[Question #3534] Concerned about oral exposure

34 months ago
Hello Dr Hook/Handsfield

11 days ago, i received unprotected oral sex from an escort in the Bronx. I think she was from some predominantly Spanish speaking country in the Caribbean or Latin 
America, possibly DR, or Puerto Rico or Cuba. This lasted for some where between 1-5 mins. We also had protected vaginal intercourse. Im already aware that the vaginal intercourse has little to zero risk of any STD. 

8 days ago i received urine tests  for gonhorrea, chlamydia and trich with a urine culture at City MD. The results came back negative for everything, although I did urinate almost 2 hours before urinating again for the test. For the past couple of days I've felt a tingling at the tip of my penis and in the urethra near the tip on and off. I dont have any discharge or pain urinating. This morning before I urinated for the first time I squeezed my penis and a very tiny amount of cloudy white fluid came out. It may be semen but im really not sure.  I plan on going back in 5 weeks to test for syphillis.

Were my tests conclusive? Or should I still be concerned I have caught something from this encounter? I have a regular sex partner and I want to make sure I keep her safe as well.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Welcome to the forum. Thanks for your question.

The oral sex event was almost as safe as the vaginal exposure, maybe even safer. Oral sex is considered safe sex, even when unprotected:  the risk is low for all STDs and zero risk for some. Chlamydia and trichomnonas are among those with little or no risk from oral sex. Gonorrhea is possible, but the urine test is highly reliable. So you can be sure you didn't catch any of those three infections. (Urinating 2 hours before testing made no difference in test reliaiblity.)

So the main issue now is whether you in fact have an abnormal urethral discharge. My guess is not:  many or most men have pre-ejaculate fluids (pre-cum) in their urethras in the morning, the result of accumulation during normal nocturnal penile erections (which occur at least 2-3 times a night in most men); or semen if you had ejaculated any time since you previously urinated. True urethral discharge usually in present in larger amount and not only in the morning; and often stains underwear. If you do have discharge, it would suggest nongonoccal urethritis (NGU), sometimes acquired by oral sex. Rather than waiting 5 weeks for the syphilis test, I suggest returning to the clinic in the next day or two, preferably at a time when you haven't urinated for at least 6 hours, for professional evaluation of possible discharge and NGU. However, my guess that all is well.

I hope this information is helpful. Let me know if anything isn't clear. If you return to the clinic, I'll be interested in hearing the result of their evaluation.